Gastrointestinal pythiosis in two cats.

Two young adult male Domestic Shorthair cats living in the southeastern United States were evaluated for signs attributable to partial intestinal obstruction. Physical examination indicated a palpable abdominal mass in each animal. Exploratory laparotomy revealed a large extraluminal mass involving the ileum and mesentery with adjacent mesenteric lymphadenopathy in cat No. 1 and an abscessed mass in the distal duodenum in cat No. 2. Mass resection and intestinal anastomosis were performed in both cats. Histologic evaluation indicated that the intestinal lesions involved primarily the outer smooth muscle layer and serosa and consisted of eosinophilic granulomatous inflammation with multifocal areas of necrosis. In Gomori methenamine silver-stained sections, broad (2.5-7.5 microm), occasionally branching, infrequently septate hyphae were observed within areas of necrosis. A diagnosis of Pythium insidiosum infection was confirmed in both cats by immunoblot serology and by immunoperoxidase staining of tissue sections using a P. insidiosum-specific polyclonal antibody. Cat No. 1 was clinically normal for 4 months after surgery but then died unexpectedly from an unknown cause. Cat No. 2 has been clinically normal for at least 9 months after surgery and appears to be cured on the basis of follow-up enzyme-linked immunosorbent assay serology.     

Experimental matrix plug production in male cat urine following a natural case of urolithiasis due to matrix plug

Urethral obstruction occurred in a 2-year-old entire long-haired red cat. A suspicion that this was a case caused by matrix plug formation could not be confirmed as reverse flushing using a topical corticosteroid and a trypsin digest appeared to have broken up the obstruction. Nine days later the cat passed a large mucoid mass which, when placed into a simulated urethra produced an obstruction. Histological examination of this plug confirmed that there were no crystalline components and on appearance it was similar to that of natually occurring matrix plugs.     

Bowel welding technique in dogs and cats using a diode laser: an experimental study

A laser bowel welding technique for dogs and cats was developed. The bowel was pinched using a special clamp having an opening on the body developed for this experiment (LW clamp). Using the 2 different types of contact probe (blunt tip: Laser Bipolar Dissector (LBD); sharp tip: Super Scalpel Dissector (SSD)), the laser passed through the hole in the LW clamp to cut the bowels, while at the same time, sealing the cut portion. The results obtained in this study showed that the optimum laser output using LBD was 6-10 W in dog and cat ileum, and 8-10 W in dog and cat colon. Optimum laser output using SSD was 6-8 W in dog ileum, 8-10 W in dog colon, 10 W in cat ileum and 6-8 W in cat colon. No marked differences were observed between ileum and colon when using either LBD or SSD. At the same power, burst pressure tended to be slightly higher with LBD than with SSD, although there were not significant differences between them. Histologically, complete sealing of the welded site was seen. Welding and cutting of bowel in dogs and cats was thus confirmed to be possible using the LW clamp in combination with LBD or SSD probes under a diode laser output of approximately 8 W for 50-80 s (400-640 J/cm). Thus, we can expect that this method is applicable to clinical veterinary medicine.     

Urinary acidification in the prevention and treatment of feline struvite urolithiasis

Two groups of 12 cats were fed ad libitum an experimental dry expanded ration high in magnesium (0.37%, dry matter basis) and similar to most commercial dry cat foods in all other nutrients. The diet of one of the groups contained 1.5% ammonium chloride, which was added to the diet before processing. Urethral obstruction developed twice in 7 of the 12 cats fed the ration without ammonium chloride. Of the 5 remaining cats in that group, 2 had calculi in the urinary bladder and urethra at necropsy. In contrast, only 2 of the 12 cats fed the ration containing ammonium chloride had urethral blockage once; neither cat had another blockage. Both cats had been catheterized twice as paired controls before urethral obstruction. One of these 2 cats died from a urinary tract infection apparently introduced through the indwelling catheter, and at necropsy there were 2 small calculi in the urethra. At the end of the study, only 1 other cat fed the ammonium chloride diet had a calculus in the urinary bladder at necropsy; this cat had not had a urethral obstruction throughout the study. After each cat had 2 urethral blockages, its diet was changed. Four cats were fed the ration containing ammonium chloride and 3, a dry, commercial ration. Of the 4 cats fed the diet containing ammonium chloride, none developed another urethral obstruction within 6 months, and at necropsy, no calculi were in the urinary bladder or urethra. Two of the 3 cats fed the commercial ration experienced urethral blockage within 3 months. These 2 cats were then fed the diet containing ammonium chloride.(ABSTRACT TRUNCATED AT 250 WORDS)     

Intestinal obstruction by trichobezoars in five cats.

Between 1997 and 1999, five domestic crossbred cats (four long haired, one short haired) presented with a palpable abdominal mass and were shown to have small intestinal trichobezoars at laparotomy or necropsy. Hair balls were associated with partial or complete intestinal obstruction and were situated in the proximal jejunum to distal ileum. In four cats obstructions were simple, while the remaining cat had a strangulating obstruction. Three of the cats were 10 years or older, and two were less than 4 years. In the three older cats abdominal neoplasia was suspected and investigations were delayed or declined in two of these cats because of a perceived poor prognosis. Predisposing factors identified in this series of cats included a long-hair coat, flea allergy dermatitis, inflammatory bowel disease and ingestion of non-digestible plant material. This report shows that the ingestion of hair is not always innocuous and that intestinal trichobezoars should be considered in the differential diagnoses of intestinal obstruction and intra-abdominal mass lesions, particularly in long-haired cats.     

Ultrasonographic and histopathological features in 8 cats with fibrotic small intestinal stricture

Benign stricture is an uncommon cause of chronic small intestinal obstruction in the cat. The purpose of this retrospective case series was to describe the ultrasonographic features, histopathological findings, and clinical presentation in a group of cats with benign small intestinal stricture. Inclusion criteria were cats presenting during the period 2010‐2017, and that had ultrasonography and small intestinal stricture confirmed at surgery. For each cat, clinical data and ultrasonographic findings were retrieved from the medical record, and histopathology, where available, was reviewed. Eight cats met the inclusion criteria. The location of strictures was duodenum (1/8), mid‐ to distal jejunum (4/8), and ileum (3/8). Ultrasonographic findings included gastric distension (8/8) and generalized (3/8) or segmental (5/8) intestinal dilation consistent with mechanical obstruction. Ingesta did not propagate beyond the strictured segment. Wall thickening was mild to moderate (3‐6 mm). Normal wall layering was disrupted in all cats. Strictures were predominantly hypoechoic (7/8) and associated with hyperechoic peri‐intestinal mesentery (6/8). Annular strictures (5/8) were less than 15 mm in length whereas long‐segment strictures (3/8) were greater than 15 mm in length. Histopathology showed transmural disease with fibrosis and inflammation (8/8), often (6/8) extending into the bordering mesentery. The mucosa was the most severely affected layer and epithelial injury accompanied the mucosal fibrosis/inflammation. Clinical presentation reflected delayed diagnosis of chronic bowel obstruction with debilitation (8/8), marked weight loss (8/8), and prerenal azotemia (5/8). Benign fibrostenotic stricture should be considered a differential diagnosis in debilitated young cats presenting with chronic bowel disease and ultrasonographic features of intestinal obstruction.     

Mitral valve dysplasia in a cat causing reversible left ventricular hypertrophy and dynamic outflow tract obstruction

A 6-month-old male European shorthair cat was examined because of a 2/6 systolic left apical cardiac murmur. Echocardiography revealed severe concentric left ventricular hypertrophy and severe dynamic left ventricular outflow tract obstruction (pressure gradient of 85 mmHg) caused by systolic anterior motion (SAM) of the septal mitral valve leaflet. After 2 months of oral treatment with atenolol, the cardiac murmur had disappeared. Echocardiography showed only slight thickening of the interventricular septum and resolution of the pressure gradient. The cat was discharged and its owner was advised to continue atenolol lifelong. Echocardiographic findings of a combination of left ventricular concentric hypertrophy and dynamic left ventricular outflow tract obstruction can be caused by hypertrophic obstructive cardiomyopathy (HOCM) or mitral valve dysplasia in the absence of hypertension and fixed aortic stenosis. In the case of HOCM, left ventricular hypertrophy is the primary process. In the case of mitral valve dysplasia, systolic anterior motion of the mitral valve is the primary problem, which leads to dynamic left ventricular outflow tract obstruction and ultimately to left ventricular concentric hypertrophy, due to pressure overload. If the left ventricular outflow tract obstruction is reduced with an oral beta-receptor blocker the secondary left ventricular hypertrophy may resolve. This would not happen in the case of hypertrophic obstructive cardiomyopathy. To the best of the authors' knowledge, this is the first documented case of severe dynamic left ventricular outflow tract obstruction and severe left ventricular hypertrophy in a cat successfully treated with oral atenolol.     

Use of bilateral temporary nephrostomy catheters for emergency treatment of bilateral ureter transection in a cat

A 2-year-old Himalayan cat was examined because of 4 days of vomiting, lethargy; and anorexia. The cat had undergone hysterectomy and removal of left ovarian remnants 5 days earlier. Results of laboratory testing and excretory urography were consistent with uremia and bilateral ureteral obstruction. Nephrostomy catheters were placed to drain urine and allow time for physiologic diuresis prior to definitive repair. During the next 2 days, the cat's physiologic status improved greatly. The cat underwent exploratory surgery, and both ureters were found to be ligated. The healthy proximal portions of the ureters were implanted into the bladder. Six months after surgery, the cat was doing well, and excretory urography demonstrated that both ureters were patent. Bilateral obstruction of the ureters is a life-threatening condition that can be difficult to correct in cats. Placement of nephrostomy catheters allows time for improvement in the cat's physiologic status prior to the protracted anesthesia time needed for surgical repair of the ureters.     

Tracheal obstruction caused by tree needles in a cat

Tracheal obstruction was suspected in a 1-year-old female domestic shorthair cat. Clinical signs consisted of inspiratory and expiratory dyspnea and cyanosis. The cat did not improve when treated with oxygen, epinephrine, prednisolone sodium succinate, and aminophylline. Bronchoscopy revealed obstruction of the trachea and carina by a 2.5-cm twig and needles from a Douglas fir tree. Needles had migrated into distal airways. The cat was euthanatized at the owner's request.     

Caudal vena cava obstruction and ascites in a cat treated by balloon dilation and endovascular stent placement

OBJECTIVE: To present details of an unusual case of caudal vena caval obstruction and its management in a cat. STUDY DESIGN: Clinical case report. STUDY POPULATION: A 15 month old male castrated domestic shorthaired cat. RESULTS: The diagnostic evaluation included the use of digital subtraction angiography and ultrasonography to locate the caudal vena caval obstruction. Treatment initially involved puncture and balloon dilation of the obstructed area of the cava. After reobstruction, the stenotic area was redilated and stented. The cat was euthanatized 4 weeks later because of vomiting, anorexia, and abnormal behavior, presumed to be associated with liver disease. CONCLUSION AND CLINICAL RELEVANCE: Interventional radiography provided a minimally invasive way to manage this unusual vascular anomaly.     

Retrospective Study: Surgical intervention in the management of severe acute pancreatitis in cats: 8 cases (2003–2007)

Objective – To evaluate clinical characteristics and outcomes of cats undergoing surgical intervention in the course of treatment for severe acute pancreatitis. Design – Retrospective observational study from 2003 to 2007 with a median follow‐up period of 2.2 years (range 11 d–5.4 y) postoperatively. Setting – Private referral veterinary center. Animals – Eight cats. Interventions – None. Measurements and Main Results – Quantitative data included preoperative physical and clinicopathologic values. Qualitative parameters included preoperative ultrasonographic interpretation, perioperative and intraoperative feeding tube placement, presence of free abdominal fluid, intraoperative closed suction abdominal drain placement, postoperative complications, microbiological culture, and histopathology. Common presenting clinical signs included lethargy, anorexia, and vomiting. Leukocytosis and hyponatremia were present in 5 of 8 cats. Hypokalemia, increased total bilirubin, and hyperglycemia were present in 6 of 8 cats. Elevated alanine aminotransferase and aspartate transferase were present in all cats. Surgery for extrahepatic biliary obstruction was performed in 6 cats, pancreatic abscess in 3 cats, and pancreatic necrosis in 1 cat. Six of the 8 cats survived. Five of the 6 cats that underwent surgery for extrahepatic biliary obstruction and 1 cat that underwent pancreatic necrosectomy survived. All 5 of the cats with extrahepatic biliary obstruction secondary to pancreatitis survived. The 2 nonsurvivors included a cat with a pancreatic abscess and a cat with severe pancreatitis and extrahepatic biliary obstruction secondary to a mass at the gastroduodenal junction. Postoperative complications included progression of diabetes mellitus, septic peritonitis, local gastrostomy tube stoma inflammation, local gastrostomy tube stoma infection, and mild dermal suture reaction. Conclusion – Cats with severe acute pancreatitis and concomitant extrahepatic biliary obstruction, pancreatic necrosis, or pancreatic abscesses may benefit from surgical intervention. Cats with extrahepatic biliary obstruction secondary to severe acute pancreatitis may have a good prognosis.     

Urethral leiomyoma in a cat

A 13-year-old spayed cat was examined because of a suspected lower urinary tract obstruction. After 2 days, a urethral catheter could not be passed, and the cat was euthanatized. At necropsy, a 1.2-cm intramural mass was detected, obstructing the proximal portion of the urethra. Histologic examination of the well-circumscribed mass revealed a urethral leiomyoma.     

Experimental infection of cats (Felis catus) with Tritrichomonas foetus isolated from cattle

Tritrichomonas foetus is recognized as the causative agent of venereal trichomoniasis in cattle. It is characterized by embryonic and early fetal death and post-coital pyometra, and feline trichomoniasis, manifest as chronic, large bowel diarrhea. Many of the infected cats are less than 2 years old and specific routes of transmission remain unknown. We recently demonstrated that feline isolates of T. foetus can successfully infect heifers, resulting in pathologic changes similar, but not identical to those previously reported as representative of bovine trichomoniasis. In this study, we experimentally infected six cats less than 1 year of age with a bovine (D-1) isolate of T. foetus and one cat with a feline (AUTf-1) isolate of T. foetus. Within 2 weeks, the cat infected with the feline (AUTf-1) isolate was culture positive for trichomonads in weekly fecal samples. At the end of 5 weeks, only one cat infected with the bovine (D-1) isolate was fecal culture positive for trichomonads. At necropsy, the intestine of each cat was removed and divided into five sections (ileum, cecum, anterior, medial and posterior colon). Contents from each section were collected and cultured. The cat infected with the feline (AUTf-1) isolate was culture positive in the ileum, cecum, medial and posterior colon. Two cats infected with the bovine (D-1) isolate were culture positive in the cecum only. Additionally, each intestinal section was submitted to a pathologist for histopathological examination. The combined results indicate that there are demonstrable differences between the feline (AUTf-1) and bovine (D-1) isolates regarding their infectivity in cats.     

Chronic ileocecal intussusception in horses

Ten young horses with signs of simple partial obstruction of the small intestine were found upon surgical exploration of the abdomen to have chronic intussusception of the distal ileum into the cecum. Poor general physical condition, intermittent or continual abdominal pain of varying degree, depression, and poor appetite were consistent clinical findings. Rectal palpation in eight animals was suggestive of an incomplete or intermittent obstruction of the small intestine. Laboratory determinations were not helpful in making a diagnosis. Dilatation and hypertrophy of the distal jejunum and ileum were associated surgical findings indicating chronicity of the problem. Surgical correction utilizing an end-to-side or a side-to-side anastomosis of small intestine to cecum resulted in recovery in 7 of 8 cases which could be followed long term. Failure to resect the abnormal segment of small intestine did not affect the outcome.     

Partial Right Ventriculectomy Using the Incised Patch Technique to Treat Double Chambered Right Ventricle and Chylothorax in a Cat

Objective— To report successful surgical treatment of double chambered right ventricle (DCRV) in a cat.
Study Design— Clinical report.
Animals— Cat with DCRV.
Methods— DCRV was diagnosed in a 5-month-old male Maine Coon cat using echocardiography and angiocardiography. At 2 years, despite medical therapy, chylothorax developed. A section of the right ventricular free wall that spanned the fibromuscular obstruction was excised under total venous inflow occlusion (TVIO) using the incised pericardial patch technique.
Results— Short-term recovery was complicated by return of chylothorax but this resolved after thoracocentesis and diuretic therapy. Three years after surgery, the cat is free of clinical signs and no longer on any medical therapy.
Conclusions— Partial right ventriculectomy can be performed under TVIO through an incised pericardial patch.
Clinical Relevance— DCRV in cat can be successfully treated by partial right ventriculectomy performed under TVIO through an incised pericardial patch.     

Fluoroscopic stent placement for the relief of malignant urethral obstruction in a cat

The clinical features and interventional therapy in the case of a female cat with urinary tract obstruction secondary to neoplasia are presented. This form of neoplasia in cats is rare and therapeutic intervention to relieve urinary tract obstruction caused by malignancy has been described only once. This is the first report of a self-expandable metallic stent placed in a feline urethra to relieve obstruction caused by malignancy and the first report of the use of a unique composite metallic stent (Platinol™) in a cat. In conclusion, the palliative stenting of the feline urethra may be a valid therapeutic intervention for malignancies. Further studies are required to determine the optimal size and type of stent that will provide the greatest benefit.     

Presumptive pseudohypoaldosteronism secondary to chronic urinary tract obstruction from sloughed urinary bladder mucosa and urinary tract infection in a cat

Objective – To describe a case of presumptive secondary pseudohypoaldosteronism (PHA) in a cat with urinary tract infection and chronic urethral obstruction. The obstruction was believed to have resulted from sloughed urinary bladder mucosa secondary to pressure necrosis. Case Summary – A 5‐year‐old, 4 kg, castrated male Siamese cat presented for vomiting and stranguria. Medical history included a perineal urethrostomy for urethral obstruction. Physical examination revealed a large, painful, nonexpressible urinary bladder. Point‐of‐care testing demonstrated electrolyte derangements consistent with a postrenal azotemia and metabolic acidosis. Results of urine culture was positive for bacterial growth. Diagnostic imaging revealed presence of retroperitoneal fluid, marked urinary bladder wall thickening, bilateral hydroureter, mild bilateral pyelectasia, and small nephroliths. The patient was treated for a urinary tract obstruction and infection. In the 3 weeks following initial discharge, the patient was evaluated on multiple occasions for lethargy, intermittent vomiting, inappropriate urination, and progressive polyuria and polydipsia. Although the urinary bladder was easily expressed during repeat examinations, it was persistently distended and subjectively thickened upon palpation. Repeat ultrasound of the urinary tract showed evidence of sloughed tissue in the bladder lumen, likely secondary to chronic urethral obstruction and pressure necrosis. A cystotomy was performed to remove the necrotic tissue, and a revised perineal urethrostomy was done due to a partial urethral stricture. Bladder biopsies were obtained at this time. Postoperatively, the cat was reported by the owners to be urinating normally but continued to be polyuric and polydipsic in the week following discharge. One week after surgery, the cat presented in hypovolemic shock with laboratory findings consistent with a presumptive diagnosis of secondary PHA. New or Unique Information Provided – PHA has not been reported previously in a cat. This case report suggests that aldosterone resistance should be considered in cats with consistent laboratory findings and a history of documented obstructive uropathy and urinary tract infection.     

IMAGING DIAGNOSIS—EXTRAHEPATIC BILIARY TRACT OBSTRUCTION SECONDARY TO A DUODENAL FOREIGN BODY IN A CAT

A 13-month-old, neutered female domestic shorthaired cat was evaluated for vomiting, anorexia, and lethargy. The cat was icteric and hyperbilirubinemic. Radiographically a partially radiolucent proximal duodenal foreign body was suspected. Ultrasonographically, there was a foreign body at the level of the duodenal papilla and dilation of the common bile duct and cystic duct; a diagnosis of extrahepatic biliary tract obstruction secondary to a duodenal foreign body was made. Sonographic findings were confirmed at surgery and a duodenal foreign body was removed. This information defines duodenal foreign body as a cause of extrahepatic biliary obstruction in cats.     

Naturally occurring xanthine urolithiasis in a domestic shorthair cat

A five year-old neutered male domestic shorthair cat was presented after three episodes of urethral obstruction and anuria requiring relief urethral catheterisation. A double contrast cystogram revealed the presence of multiple small cystollths which were radlolucent on plain radiographs. A perlneal urethrostomy and a cystotomy were performed to relieve the urethral obstruction and to remove the cystoliths. Quantitative analysis revealed the cystoliths to be composed of 100 per cent xanthine. Clinical history suggested the xanthinuria to be naturally occurring. Unfortunately, the cat was killed in a road traffic accident two months after the surgical procedure, preventing further long-term assessment.